• NEWS . 19 Oct 2020
  • Modified HEART score effective as a predictive tool for MACE in Asian patients

  • Chest pain is the most common potentially life-threatening presentation to the emergency department (ED). Additionally, the diagnosis of acute coronary syndrome including its risk stratification and subsequent disposition can be challenging. The original HEART score is a predictive tool used to risk-stratify patients presenting with undifferentiated chest pain and aid physician decision-making; however, it utilizes conventional troponins as its cardiac biomarker component. 

    In this study, researchers sought to assess the utility of the modified HEART score with highly sensitive troponins in an Asian setting with mixed ethnicity. Clinical data from 413 patients presenting to the ED for evaluation of chest pain were analysed, and the predictive value of the modified HEART score for determining major adverse cardiac events (MACE) evaluated.

    Results showed that 49 patients (11.9%) had MACE: 31 patients (7.5%) underwent percutaneous coronary intervention and 1 patient (0.2%) underwent coronary artery bypass surgery. There were 17 (4.1%) deaths. Three risk groups were elucidated based on MACE: the low-risk group (0–2) of 17.4% of the patients, with a MACE rate of 1.4%; the intermediate-risk group (3–5) of 56.4% patients, with a MACE rate of 5.2%; and the high-risk group (6–10) of 26.2% patients, with a MACE rate of 33.3%.

    These findings corroborate previous Chinese studies and provide additional evidence that the modified HEART score is an effective risk stratification tool in an ethnically diverse Asian population, with a further benefit of identifying low-risk patients who are candidates for early discharge from a local ED. 

    Sajeed SM, et al. Performance of the modified HEART score in an Asian population. Int J Emerg Med 2020;13:43.